Using the Candidacy Framework to understand how doctor-patient interactions influence perceived eligibility to seek help for cancer alarm symptoms: a qualitative interview study

Tookey, Sara, Renzi, Cristina, Waller, Jo, von Wagner, Christian and Whitaker, Katriina (2018) Using the Candidacy Framework to understand how doctor-patient interactions influence perceived eligibility to seek help for cancer alarm symptoms: a qualitative interview study BMC Health Services Research, 18, 937.

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Abstract

Background:

‘Candidacy’ is concerned with the way people consider their eligibility for accessing health services. We used the Candidacy Framework to explore how the doctor-patient relationship can influence perceived eligibility to visit their General Practitioner (GP) among people experiencing cancer alarm symptoms.

Methods:

We carried out a secondary analysis of qualitative interviews with 29 women and 33 men, aged ≥50 years experiencing cancer alarm symptoms, recruited through primary care. Interviews focused on symptom experience, help-seeking and primary care use. Framework analysis was used to analyse transcripts with a focus on GP-patient interactions.

Results:

Perceived (im)permeability of services acted as a barrier to help-seeking, due to limited availability of appointments, time-limited communication and difficulties asserting candidacy. There was also a focal role of communication in building a positive doctor-patient relationship, with some participants describing resisting offers of appointments as a result of previous negative GP adjudication. These factors not only influenced the current consultation but had longer-term consequences for future consultation.

Conclusions:

Candidacy provides a valuable theoretical framework to understand the interactional factors of the doctor-patient relationship which influence perceived eligibility to seek help for possible cancer alarm symptoms. We have highlighted areas for targeted interventions to improve patient-centred care and improve earlier diagnosis.

Item Type:	Article
Divisions :	Faculty of Health and Medical Sciences > School of Health Sciences
Authors :	Name Email ORCID Tookey, Sara Renzi, Cristina Waller, Jo von Wagner, Christian Whitaker, Katriina k.whitaker@surrey.ac.uk
Date :	4 December 2018
DOI :	10.1186/s12913-018-3730-5
Copyright Disclaimer :	© The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/ ), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated.
Uncontrolled Keywords :	Candidacy; early diagnosis of cancer; help-seeking behaviour; primary health care; qualitative research; signs and symptoms
Depositing User :	Melanie Hughes
Date Deposited :	20 Nov 2018 15:19
Last Modified :	13 Jun 2019 10:57
URI:	http://epubs.surrey.ac.uk/id/eprint/849906

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